Provider Demographics
NPI:1033599238
Name:CORCORAN, DANAMARIE (SLP CFY)
Entity Type:Individual
Prefix:MISS
First Name:DANAMARIE
Middle Name:
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:SLP CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 WATKINS AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1520
Mailing Address - Country:US
Mailing Address - Phone:718-702-4143
Mailing Address - Fax:
Practice Address - Street 1:2460 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6612
Practice Address - Country:US
Practice Address - Phone:646-267-9709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist